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Korean J Radiol. 2015 Nov-Dec;16(6):1332-40. doi: 10.3348/kjr.2015.16.6.1332. Epub 2015 Oct 26.

Radiofrequency versus Ethanol Ablation for Treating Predominantly Cystic Thyroid Nodules: A Randomized Clinical Trial.

Author information

1
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
2
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. ; Department of Radiology, Ajou University School of Medicine, Suwon 16499, Korea.
3
Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, Seoul 07442, Korea.
4
Department of Radiology, Chung-Ang University College of Medicine, Seoul 06973, Korea.
5
Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.

Abstract

OBJECTIVE:

To compare single-session radiofrequency ablation (RFA) and ethanol ablation (EA) for treating predominantly cystic thyroid nodules (PCTNs).

MATERIALS AND METHODS:

This single-blind, randomized trial was approved by the Institutional Review Board of two centers and informed consent was obtained from all patients before enrollment. Fifty patients with a single PCTN (cystic portion less than 90% and greater than 50%) were randomly assigned to be treated by either RFA (25 patients) or EA (25 patients) at two hospitals. The primary outcome was the tumor volume reduction ratio (%) at the six-month follow-up and the superiority margin was set at 13% (RFA minus EA). Analysis was performed primarily in an intention-to-treat manner. The secondary outcomes were the therapeutic success rate, improvement of symptomatic and cosmetic problems, and the number of major complications.

RESULTS:

The mean volume reduction was 87.5 ± 11.5% for RFA (n = 22) and 82.4 ± 28.6% for EA (n = 24) (p = 0.710; mean difference [95% confidence interval], 5.1% [-8.0 to 18.2]), indicating no significant difference. Regarding the secondary outcomes, therapeutic success (p = 0.490), mean symptom (p = 0.205) and cosmetic scores (p = 0.710) showed no difference. There were no major complications in either group (p > 0.99).

CONCLUSION:

The therapeutic efficacy of RFA is not superior to that of EA; therefore, EA might be preferable as the first-line treatment for PCTNs.

KEYWORDS:

Ethanol; Predominantly cystic thyroid nodule; Radiofrequency; Thyroid; Ultrasound

PMID:
26576124
PMCID:
PMC4644756
DOI:
10.3348/kjr.2015.16.6.1332
[Indexed for MEDLINE]
Free PMC Article

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